Spinal Care in an ageing population

Please complete this survey to assist ParaQuad to advocate on increasing the current Aged Care benefit to cater for the needs of people with Spinal Cord Injury

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* 1. Name (optional):

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* 2. What is your age bracket?

0-14 years

15-24 years

25-34 years

35-44 years

45-54 years

55-64 years

65-74 years

75 years and over

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* 3. Date of Injury:

Enter the date of your injury

Date

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* 4. Level of Injury

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* 5. ASIA Classification